Medicine 2019: Stop using the word burnout says RCP president

In his keynote speech to the RCP’s annual conference in Manchester today, RCP president Professor Andrew Goddard says we need to stop using the word burnout in relation to doctors as that implies a failure of the individual.  He says we need to make it clear that healthcare staff are ‘injured’ by the overstretched system.

Our trainees are suffering burnout, our consultants are suffering burnout, even our medical students risk burnout. Hang on though, this is not the word we should be using. What we call burnout, that sense of despair, hopelessness and loss of joy is not due to a failure of the individual. It is a failure of the environment they work in, the culture of the workplace, the workload imposed on this. Some, particularly in the United States, have started to call this process ‘moral injury’ as it puts the onus back on the system.

What we call burnout, that sense of despair, hopelessness and loss of joy is not due to a failure of the individual. It is a failure of the environment they work in, the culture of the workplace, the workload imposed on this

Professor Andrew Goddard, RCP president

Professor Goddard also outlines the reasons for the situation healthcare staff find themselves in – the growing pressure of emergency admissions and workforce shortages:

Since I became a consultant in 2002 the number of emergency admissions has increased by over 50% with a reduction of bed numbers by over 25%. The only reason the NHS house of cards has not collapsed is that we as a health service have been working harder and harder to get length of stay down, but looking at the trajectory of the decline in length of stay this is plateauing.

We feel busy, not just because the admissions are going up but because there are not enough doctors. The number of consultant posts we have been able to recruit to has fallen year on year over the past decade. The maths is simple. Last year just under 1400 consultant physician posts were advertised and we recruited to 800. The number of medical registrars gaining their CCT was, you’ve guessed it, 800. Worse still, we probably lose 25% of all doctors between entering medical school and becoming a consultant, let alone the large number that retire early due to pressures of work and perverse financial incentives.

Professor Goddard says he is awaiting the new Workforce Implementation Plan from NHSE and NHSI, but underlines how important it is for doctors to support each other:

I am well aware, though, that local culture is driven by our behaviours as doctors and we too must step up to the plate. Talking about the negatives will not achieve much. We need to highlight the positive ways we can support ourselves and each other… I will continue, unashamedly, to tell everyone I can why I think medicine is brilliant and how we can support each other.